Dianne Grace Mallik, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC3885 Issued in CA

Practice address

2330 Main St Ste D
Ramona, CA 92065-2539

Phone

(858) 208-8250

NPI assigned

Mar 6, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Dianne Grace Malik Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1508282138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17218 BOCA RATON LN",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920641304",
            "telephone_number": "802-734-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 MAIN ST STE D",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920652539",
            "telephone_number": "858-208-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIK",
        "first_name": "DIANNE",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-06",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VT",
            "license": "091.0000161",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC3885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANNE",
            "last_name": "MALIK",
            "middle_name": "GRACE",
            "prefix": "MISS",
            "credential": "L.AC.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valerie Jean Lucio, MFT
• Valeria Maciel
• Trudy Michelle Madden, LVN
• Raul Oscar Madrigal
• Malcolm J Boykin DDS Inc
• Heather Mallon, FNP-BC
• Marcelo R. Rivera MD, Inc.
• Ria Costales Martin, FNP
• Daron Mathena, DACM, L.AC.
• Michael Brandon Mazzola, RN

• Acupuncturist in Ramona, CA
• Providers in Ramona, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.